Mania Dramatic shift in mood, emotions & energy → extreme shifts Changes are NOT minute to minute → over several days/weeks delusions racing thoughts no need & sleep pressured & rapid speech low mood major depressive disorder (Unipolar depression) ↓ hopeless, discouraged lack of energy & focus, ↓ or ↑ sleep, eating disorders hypomania (Hypomania) ↓ ↑ happiness, confidence self-esteem, euphoria ↓ reckless & risky behaviours → if untreated → can last 3-6 months physical features MANIA ≥ 1 wk or hospitalisations BIPOLAR II normal person mood ↓ hypomania ≥ 4 days can last longer less severe than in DEPRESSION ≥ 2 wks UNIPOLAR DEPRESSION ↓ normal highs crushing lows willer lows & highs (hypomania) cycling between ≥ 2 not needed for a diagnosis BIPOLAR I depression present in most cases CYCLOTHYMIA may not have obvious triggers Other features mixed → depression + mania @ the same time rapid cycling → 4 or more episodes of depression or mania within a given year Cause unknown → genetics + environment ↓ no specific gene yet identified If HIV drugs/meds e.g. SSRIs Often also have anxiety substance abuse ADHD personality disorder makes DX & Tx hard Tx no cure important → self-harm & suicide prevention Lithium salts → better @ treating mania than depression episodes mood stabilizers → smoothers highs + lows anti-psychotics anti-convulsants benzodiazepines often b after relapse e.g. anti-depressants such as SSRIs ↓ can trigger manic side effects ↓ may cause non-adherence psychological interventions e.g. talk therapy, CBT ↓ not very effective for management of bipolar disorder useful after a manic episode may be helpful such as in helping someone handle stressful situations that may otherwise lead to a manic episode